HomeMy WebLinkAboutSHER FIVE POINTS - 1984-08-06 (2) RE LIES FOR CITY COU C[_ACTl N.
Date July 25, 19i.4 _
City M bl onorae Mayor and �' COUN�iT '
Submitted to: h Y Y Council ��7• =t L�Ltj !�
C. W. Thompson, Cis Administrato ' w;
Submitted by: p � "y G '�"
Prepared by; Paul E. Cook, Director_ of Public Works' ' P .CLTY
Subject: Parkway License Agreement for Sher Five- ruts (File #84-17)
Statement of b-sue, Recommendation,Analysis, Funding Sources,Alternative Actions,Attachments:
STATEMENT OF ISSUE:
In order for Sher Fiva Points to provide and maintain landscaping within
public right-of-eray, a Parkway License Agreement must be executed between
the developer and the City.
RECOMMENDATION:
Execute the Parkway License Agreement between the City -nd Sher Five
Points.
ANALYSIS:
A condition of approval for Conditional Exception 84-3 required Sher
Five Points to enter into; an agreement with the City for maintenance
of landscaping and other improvements within the public right-of-way
of Ellis Avenue and Delawa_e Street. This allows the developer tr
integrate his on-site landscape scheme into the public right-of-way
resulting in a more aesthetically pleasing landscape appearar.::e.
FUNDING SOURCE:
None required
ATTtic HMENT:
Parkway License Agreement
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, ITS - I �4 2000 MAIN STREET CALIFORNIA 92648
OFFICE OF THE CITY CLERK
S..
October 2, 1984
Sher Five Points
200 -• 112th Street NE #213
Bellevue, WA 98004
The City Council of the City of Huntington Beach at its regular meeting
held Monday, August 6, 1984 approved a Parkway License Agreement with
your firm.
Enclosed is a copy of the duly executed agreement which has been recorded
in the Office of the County Recorder.
Alicia M. Wentworth
City Clerk
AIAW:CS:js
Enclosure
cc: Bill Patapoff - DPW
Judy John - France
1
(T*Aaphone:714.536.5227(
. EXEMPT
i C5 84-383759
PARKWAY LICENSE AGREEMENT
BETWEEN THE CITY OF HUNTINGTON BEACH AND SHER FIVE POINTS
THIS AGREEMENT made and entered into this day of
19 84 , ny and between the CITY OF HUNTINGTON BEACH,
a municipal corporation of the State of California, hereinafter
referred to as "CITY, " and SHER FIVE POINTS, a tenancy in common,
hereinafter referred to as "LICENSEE. "
WHEREAS, in connection with the Five Points Shopping Center,
local.,,-! in the City of Huntington Beach, County of Orange, State of
California, and more particularly shown on Exhibit "A", LICENSEE
will be required by the Department of Public Works of CITY to
provide landscaping, maintenance and other improvements in the
public right-of-way in accordance with plans and specifications
submitted by LICENSEE and approved by CITY.
LICENSEE and CITY desire to specifically delineate their
.respective obligations with respect to the maintenance of the
improvements of the aforedescribed area on Ellis Avenue and Delaware
Street, as shown in Exhibit "A. "
NOW, THEREFORE, the parties agree as follows:
?. LICENSE
CITY grants to LICENSEE a license to utilize the
IMPROVEMENT AREA for landscaping purposes.
2. TERMS
The term of this license shall be perpetual, provided that
CITY may at any time terminate this license upon thirty (30) days
w itten notice to LICENSEE.
RECORDED IN OFFICIAL RECORDS
OF ORANGE COUNT Y CALIFORNIA
RE.GORol RE)UESTED
SY AND MAIL TQ -11 S0 Aft .SEP 1 7'84
A i" CUONly
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MW 9 84-383759
3. MAINTENANC OF IMPROVEMENT AREA
During the term of this License, LICENSEE, and/or its
successors and assigns agrees to maintain the existing improvements
of the area shown in Exhibit "A" and designated thereon as the "area
within the agreement" in good and satisfactory condition.
Maintenance shall include, but shall not be limited to, watering,
repairing and adjusting irrigation sy. tems when failures occur,
fertilizing, cultivating, ed, :_.a, performing general planting and
trimming or other corrective gardening, spraying grass and plants
with both insecticides and herbicides, and generally keeping the
landscaped area in a clean, safe and attractive condition, taking
into consideration normal growth of the landscape material and a
continuation of the aesthetic quality of the area. The growth of
all plant materials shall be controlled so that none protrude into
pedestrian, bicycle or street areas to obstruct -)r hinder bicycling,
walking or driving traffic. Water, soil or other materials shall
not be allowed to flow or spray across or onto the bicycle path,
pedestrian walk or street right-of-way from the edge of the
curb/gutter to he center of the street as designated on Exhibit
"A." IMPROVEMENT AREA shall be free from weeds, debris and harmful
insects at all times. All such gardening and maintenance practices
so performed shall conform to the best maintenance practices and to
the Arboricultural and Landscape Standards and Specifications issued
by the Department of Public Works of CITY.
4. DAMAGE
In the event any damage is caused to the pathways,
sidewalks, curb, street or utilities as a result of the installation
2.
84-383759
of the landscape qaterial installed and/or maintenance of the
IMPROVEMENT AREA, LICENSEE and/or its successors and assigns agrees
to repair same at its own expense.
5. ENFORCEMENT BY CITY
In the event LICENSEE and or its successors and assigns do
not maintain IMPROVEMENT AREA in an adequate manner, CITY shall
cause such maintenance to be perf^r!ned adequately and all costs
incurred therein by CITY shall be assessed : o and billed directly to
LICENSEE and or its successors and assigns. Payment sha..1 . .: due
within ten (10) days of billing from CITY.
G. MODIFICATIONS
LICENSEE and/or its successors and assigns shall make no
m•--ter-al change in the placement or type of plant material or other,
improvements utilized within IMPROVEMENT AREA nor shall the design
of IMPROVEMENT AREA oe materially changed without prior written
consent of CITY.
7. SEPARATE ASSIGNMENT
This license is ap;,urtenant to the parkway on Ellis Avenue
and Delaware Street, as shown in Exhibit "A" and may not be
separate4.y assigned apart from the defined area.
i
8. INSURANCE AND INDEMNIFICATION
For the term of this agreement, LICENSEE and/or its
successors and assigns shall provide public liability insurance and
agree to name the CITY as an additional insured and to hold CITY
harmless as follows:
1) Combined single limit bodily injury and property
damage: $300,000 ir_ the aggrejate.
Y
3.
1
s
84-383759
2) Additional Insured Endorsement: LICENSEE agrees to
name, in said public liability insurance policy as
additional insured, the CITY OF HUNTINGTON BEACH, its
officers and employees, when acting as such.
3) LICENSEE agrees to protect, defend, indemnify and hold
harmless C_ ' its officers and employees, against
loss, damage, expenses or liability by reason of any
suits, claims, demands, or judgments caused by
LICENSEE, its employees or agents, including
independent contractors employed 'by it, arisir out of
or in consequence of the performance of _,4is t eement.
9. NONDISCRIMINATION
LICENSEE agrees that in the performance of this agreement
and use of the IMPROVEMENT ARE: , it will not engage in, or permit
agents to engage in, discrimination against any person because of
race, religious creed, color, national origin, ancestry, physical
handicap, medical condition, marital status or sex.
10. .BINDING EFFECT
This instrument shall bind and inure to the benefit of the
owners of Five Points Shopping Center and their respective
successors, heirs, personal representatives and assigns, provided,
however, that any person who conveys, assigns or sells by recorded
deed all of his or her interest in the property described in Exhibit
"A" shall thereafter be released from all duties and obligations r
under this agreement arising after the date that such person gives
j
written notice of assignment to the CITY.
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4. s
11. RECORDING 8 4`3 8 3;S 9
This agreement shall be recorded with the Counry Recorder
of Orange County, California.
12. ATTORNEY'S FEES
In the event of any controversy, claim or dispute relating
to this instrument or the breach thereof, the prevailing party shall
be entitled to recover from the losing party reasonable e-:penses,
attorneys ' fees and costs.
13. MISCELLANEOUS
This instrument contains the entire agreement between the
parties relating t ) the rights herein granted and the obligations
herein assumed. Any oral representations or modifications
concerning this instrument shall be of no force and effect excepting
a subsequent modification in writing, signed by the party to be
charged.
IN WITNESS WHEREOF, the parties hereto have caused this
agreement to be executed by and through their authorized officers
the day, month and year first above written.
SHER FIVE POINTS, CIRCLE A. SHER TRUST
a Lena cy in commo )
i
s
By 1 By
S SHER, Andividually MERRIT SHER, Trustee e
By By /
RO D SHER, Executor for PAMELA SHER, Trustee
the Estate of Sydney Sner
5.
STATE OF CALIFORNIA � ss
COUNTY OE' ORANGE 8 4-3 8 3 7 5 3
On this ( day of 5�' orn�t- , 19 �, before me,
a Notary Public .in and for said County a d State, personally appeared
�6.c-�< Ke(I , known to me to be the Mayor
and \ wwtv_,nrt , known to me to be the City Clerk
of the City of Huntington Beach, the mi'micipai corporation that executed
the within instrument, known to me to ;.)e the persons who executed the
within instrument on bahalf of :.aid municipal corporation and acknowledged
to me that such municipal corporation executed the same.
w OFFICIAL SEAL
EVELYN SCHUBERT
Notary Public-Callfornla
ORANGE COUN Y
My Comm.Exp.Mar.30,1s3�1
84-3837;.y11)
" SARM ENTERPRISES, JUSTIN WISHER TRUST:
a General Partnership
Y _ Y
AB Y SHER, 0 e al Partner MERRITrSHER, Trustee
RON;Aj
D SHER, General Partner PAMELA SHER, Tfustee
r• T.By � LACEY L. SHER TRUST:
MERRIT(SHER, General Partner
.By V/ Q_� B,V��`A�J�,�
SHER, I :I.iv'dually ME}R�RIT SHER, Trustee
BY BY 1 � �ti� -tJ� Uj-
RTNALD SHER, Individually PAMELA SHER, Trustee
RACHEI SHER TRUST: REBE SHER TRUST:
By By
RO D SHER, Trustee RO ALD SHER, Trustee
B By ^� a
Y _
VA-MARI SHER, Trustee EVA-MARIE SHER, Trustee
CIT OF TIh4TON E ,
a U. -pa c for r
0
ATTEST: APT V S 0 FORM:
Cate Clerk C%ty Attorney T y= s,�'/
REVIEWE, D APPROVED: I TXAT-ElrAND,cPP VED:
City dminist r Director of Public [works
6.
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EXI 63/T A "
• n LL'TY.
.. 84-383758
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EOF CA
LIFOR
COuo ' ss 84-383759
ON�,,....,.�""� -"fit +`- ? 19���,before me,the
undenigned, a N .Public in and for said County and Mate, personally
appmvd SYLVIA SHER
personally known to me (or proved to erne on the basis of satisfactory
evidence)to be the peisoon.,._,.rhoet name.,.i z subacribed to the within
instrument, ,end acknowledged to me that she, executed the same. �0, ��
�� ��wam OFFICIAL SEAL
l � r s.
'W.OMrbsisaMW _—__ 'L"� 11f: �. l/llZ-�a •a^°- gJIILD�+w�� F ars�A
,Afly puauC
GENERAL L AC h trams 4 e'Y F P pRYSSC1pAL OFFICE IN
s `r LO"sANCEIES fCUYi1B 1985
.�ar,�s� Ydy CommiSs�on ExG. ��
m sn
Is m,®ev cucsam
S'TA'TEO1F WASHINGTON
COUM11-Y OJF._,KTNc SS
ON
'7TM,��
.,,_ �/� ``���� 42-� f 19 � , before me, the
unders�nKl, a Motan public in and for said County and State, personally
aappearad BALD SH
_MB,_Executor for the Estate
of_Sydney Sher
peronaally known tic ante (or proved to me an the hasiis, of satisfactory
evidenccc)to be the Person.._,. whom aaame- s auabscribed to the +vvitWn
instrument,and acknowledr'd arse that—he—execlited ne e3me.
GENERAL ACKNOWLEDGMENT -
STATE OF CA.LIIiIrIA ,. .�t S5
COUNTY
Ol*d �' l9 r> ;,before rate,the s• `et ��z
undersigned, a Notary Fublic in and for said County and State, personally
appe.=d MERRITT SFiER Trustee for circe A, Sher o
� O
C N proved to me on the basis of satisfactory b m O
personally known to m® (or pro ro W ap r
evidence)to be the person_whose nanne—Is --subr�cribed to the within r o
ri a
instrument,and acknowled do me that—he.�a ecuted the same. A� n r
GENERAL ACKNOWLEOGMENT
STATE Or `t _ O A
COUNTYO� ��, ����,. _gin � SS qb 84-383759
ON L1 Ut/�G.1it �7 i g ,befom me, the
undcffined, a Notary Public in and for said Count and State,, personally
appeared PAMELA SHER, Trustee for Circe A. Suer Trust
pzwnally known to me (or proved to me on the basis of satisfactory � o
evidence) to be the person___.,.whose names subscribed to the within E ti'
lnotrument,and acknowle d to me that
-� —Qhe x uted the same,
Notary's S182at®m
GENERAL ACC OWLEDCMENT "-" p
Or r
F
w '-'-
�+ A
STATE OF CAL[FORNLl j
COUNTY OF_ 4J i: SS
ON^ 1'�' 19j'�� , before me, the
undersigned, a N tary Public in and for said County and State personally
appeared ABBY SHER, General Partner of
SARM Enterprises personally known
to me(or proved to me on the basis of satisfactory evidence) to be one of
the partners of the partnership that executed the within instrur �,®and
acknowledged to me that such artnershi execs,ted the.same. rJ
g P p j
Notary's Siignawre
PAft'rNERSHIP ACKNOWLEDGEMENT �o `s^ 6ntt>
rs `� �' ps; t� ,
cos ..�G,.r
�1aiL Z0 1410" —S
r
''�csb�fxp t,0�111,
1,94
STATEOF WASHINGTON ! SS
COUNTY OF KING !
ON � �3 19 ��; before me, the
undersigned, a Notary Public in and for said County and State personally
appeared RONALD SHER, General Partner of
SARM Enterprises personally Known
to me (or proved to me on the basis of satisfartory evidence) to be one of
the partners of the partnership that executed the within instrument, and
acknowledged to me that s partnership execs red the
NotrrY's SignAWse j �^---� t
PARTNERSHIP ACKNOWLEDGEMENT
A STATE OFOFCALIF gs 8 4-3 �3 7 5 9
COUNTY OF
ON,.� / 19_k_T_,before me,the z,
widersigned, a Notary Public in and for said County and State personally
appeared MERRITT SHER, General Partner of _ o
SARM Enterprises _ personally known
— ^., c T_cq�..
to me (or proved to me c . the basis of satisfactory evidence) to he one of { o o
the partners of the partnership that executed the within instrument, and t,r, v O r„
r T V)
acknowledged to me that ch partnership executed t ani e- { A 0 M r
No '8 S t re
tart iL•n.
PARTNERSHIP ACKNOWLEDGEMENT
STATE OF CAL&,QRNIA �
COUNTY®F tc% ' � ');6b' &L'<11. SS
cJ
ON Z.d� C! a
z. a 1 , before me, the
undersigned, a No sy Public in and for said County and State, personally
appeared_.... ABBY SHER
�J
personally known to me (or proved to me on the basis of �ti6facto`1
evidence?to be the pemn—whose name is subscribed to the witilin°ba ,;n � 0��
°
instrument,and acknowledVd to me that r he executed the �ei. °o^ 'QC'y�`c
op
GENERAL ACAMOWLED(,MrFPrS ®oO ICP
ST'AT'FOF WASHINGTON
COUNTY OF KING } SS T,
ON �1 19 /_, before mo, the
undersigned, a Notary Pu 'c in :and for said County and State, parsonaUy
appeamd RONALD SHER
personally known to We (or proved to :fie on &.a basis of eaatisfactory
z-eidence)to be the arson_,.whose harm i s subscribed to the within
instrument,an-di acknowledged to mZ:IZK=�
that Sias►aetto
a ENMAL arCKNOWLEDGEUMr
STATE OF WAS 1_LInN � SS8�-383759
O.FON 19-f4,before me,the
under ed, a$ T3ot3a'y Pitbli in and fo^said County and State, perrson&BY
RONALD SHER, Trustee for Rachel. M. Sher Trust
appeared - -
personally known to me (or proved to me an the basis of satisfactory
evidence)to be the pawn_.—whose name is subscribed to the within
instrument,and acknowledged to nee that.,_._he—executed he sass;e.
No wy'a Si�wKvrm —
GENERAL ACXN0V Et3GED MT
STATE OF WASHINGTON � S5
COUNTY OF KING
ON 3, 19 , before me,the
undersigned, a Notary Public and for said County and State, personally
appeared EVA MARIA SHER, Trustee for Rachel M. Sher Truut
perrnaally known to are (or proved to me on the basis of satisfactory
evidence) to be the person.—whose name is subscribed to the witizin
instrument,and acicnowledfed to me that s�heeJ/_ _executed the same. t
Notay'6$agnatur0.
GENEILAL ACKNOWLEDGEMENT
t y
STATE OF CAUFO? 1A SS
ON _ �+ 7 7 19 ,before me,the
urdeasaigned, a Notwy Public in and for said County and State, .personally
appeared MERRITT SHER, Trustee for Justin W. Sher
True+ a
� gJJTG
personally known to me (or proved to me on the basis of satisfactory
evidence)to be the person—whose name, .s - subsicribed to Uie within 0.
ZP
instrument,and a�cknowl d to me that__ he___ a ecutod the same. r O�
` „c_-n >
m
Afatiay'a at8trc , a 2`J C'
GENERAL ACKNOWLErrC'ra UENir � D
STATE OF CALIFO � 84-383759
WUN I yf O1F �� SS
ON 2-7 19�before me,the
undersigned, a Notary Public in and for said County and State, personally
appeared PAMELA SHER, Trustee for Justin W. Sher
Trust o
--— -- w r O
personally ltrroevrr to rrre (or proved to me on the basis of utisfffictory
evidence)to be the i s b.person�vvho�Warne subscribed to the within
instrument,and ecknow 'P�d to me that—.z he_ ec ted the same. v o w+
t-. m a
Notuy't Sb$aaturo / __ p r C
77—
GENERAL ACKNOWVLEDGADJAEla �' y
STATE OF CALIFOM IA S5
COUNTY OFr
ON 2"� ��, 19. , before me, the ;
undersigned, a Notary Public in ar;d for said County and State, personally
appeared— MERRITT SHER, Trustee for Lacey L. Sher
Trust
0
personally known to me (or proved to me on the basis of satisfactory Z
% r 0
evidence)to be the person_.._.whose name i s subscribed to the within
instrument,and acknowled to me that—he__ ex uted the same. , 'r 0
�
PJotaay'a Se�aat�+ro
V r
GENERAL ACKNOWLEDGEMENT
z
STATE OF CAL 1A SS
COUNTY F_
ON 19 ,before me, the €'
undersigned, a Notary Public in and for said County and State, personally
PAMELA SHER, Trustee for Lacel L. Sher Trust r
app=ed o
to q3�
a n v G)
personally known to me (or proved to me on the basis of satisfactory y o r
a 'N0
evidence)to be the person—whose name_. i s subscribed to the within H n Ica E„
>o r�
instrument,and acknowled to me.that she xecuted the same. p rP`
ldotsry's S;graswca
GENERAL ACKNOWLEDGF-MENT
84-383759
STATE OF WASHINGTON � SS
O KING
ON_____. � ��' , 19 before me, the
undersigned, a Pdotary Public and for said County and State, personally
appe, RONALD SHER, Trustee for Rebecca Sher Ti st
personally known to me (or proved to me on the basis of satisfactory
evidence)to be the person—whose name is subscribed to the within
instrument,and acknowledged to me that—he__, exocuod the same.,
GENERAL AC7tN0LEDGEMEXT
STATE OF WASHINGTON
COUNTY()l? KING SS
ON 19 , before me, the
undersigned, a Notary Public in and for said County and State, personally
appeared EVP--NIARIA SHER, Trustee for Rebecca Sher
T -ust
a
personally known to me (or proved to me on the basis of satisfactory
evidence) to be the person—whose name is subscribed to the within
instrument,and acknowledge#to me that s he ex cuted Sh same.
Notary's swuturo }
GENERAL ACKNOWLEDGEMENT
i
4
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R(TMN'TO: CERTIFICATE OF INSURANCE Approved as to Form:
City of I[untint L Beach TO Gail Hutton,City Attorney
Ins.& Ben.Offiee CITY OF HUNTINGTON BEACH, CALIFORNIA
P.O. Box 190 By: ITIJ
Huntington Beach,CA 92648 A MUNICIPAL CORPORATION
This is to certify that the policies of insurance as described below have been issued to the insured by the undersigned and are in force
at this time. If these policies are cancelled or changed in such a manner that will affect this certificate,the insurance company agrees
to give 10 days prior,written notice, by mail,to City of Huntington Beach,P.0.Box 711,Huntington Beach,California 92648.ALL
ITEMS MUST BE COMPLETED, ANY DELETION OR CHANGE IN THIS FORM SHALL BE SIGNED AND DATED BY AN
AUTHORIZED REPRESENTATIVE OF THE INSURANCE COMMg NY AND MUST BE APPROVED IN WRITING BY THE CITY
ATTORNEY.
Name of Insured SHER FIVE POINTS
Addressof Insured 200-112th Ave. NE, 4213, Bellevue, WA 98004
Location of Work or Operations to be performed Loehmann's Five Points Shopping Center
Main Street, Fluntington Beach, CA 92648
Description of Work or Operations
POL C LIMITS OF LIABILITY J NAME OF COMPANY
POLICIES IN FORCE POLICY NO. Effective Expiration In Thousands MGM (INS.)
GENERAL LIABILITY
j/,/97
K COMPREHENSIVE FORM $ 00,000 CSL
(X) PREMISES—OPERATIONS
Each Occurance � ,4
[ J EXPLOSION AND
COLLAPSE HAZARD
[ j UNDERGROUND HAZARD
b(J PRODUCTS COMPLiFTED
OPERATIONS HAZARD
D(I CONTRACTUAL
INSURANCE
[ I BROAD FORM
PROPERTY DAMAGE
[jQ INDEPENDENT
CONTRACTORS
[)0 PERSONAL INJURY
AUTOMOBILE LIABILITY
[ I COMPREHENSIVE FORM
( J OWNED $ CSL
Each Occurance
[ ) HIRED
[ j NON-OWNED
EXCESS LIABILITY
[ 1 UMBRELLA FORM $
[ j OTHER THAN
Uh BRELLA FORM
WORKERS'COMPENSATION
and
EMPLOYERS'LIABILITY
Additional Insured Endorsement:
The insurer agrees that the City of Huntingrol. Beach and its City Council, and/or all ',:ity Council appointed groups,committees,
commissions, boards and any other City Council appointed body,and/or elective and appuintive officers,servants or employees of the
City of Huntington Beach, when acting as such are additional insureds hereunder for the acts of the insured,and such insurance shall
be primary to any insurance of the City of Huntington Beach,as their interest may appear.
Date AUTH R[ZED REPRESENTATIVE OF INSURANCE COMPANY
i
INSURANCE COMPANY �1 Qr„..� 7�Nr\�vr�Q 7-r[s, &• By
Name Address A n C I ,
Address 17017 7�
City
City A _ 30.E I8 �yoy) JSa- 9f00
d Telephone
HOLD HARMLESS AGREEMENT
(to be executed by insured)
The insured*-- —,agrees to protect,defend, indemnify, save, and hold harmless the City of Huntington Beach its
officers, agents, attd employees against any li -ity, foss,damage, cost, or expense by reason of any and all liability,suits, claims,
demands,judgments and causes of action Maus d b insured,his employees agents or any subcontractor or by any third party arising
out of or in consequence of the performance f all or anylloperijons or activity f 4ih—tbiS.ertificate of insurance is furnished.
*0) Sole Proprietorship '"' 4 Partne ) C ation 4)Other(state) Tenancy in Common
HOLD HARMLESS SIGNED: 6y Managing Insured:M— _ Title g g Owner. }�
(All names.shall be printed or,t pod i?rnald Sher for SHER
below each signature.) VIVE POINTfi �i
By Insured:_ tlo
s
If Corporation,TWO Officers must sign,or present evidence of authorization to bind Corporation.
iti:'rlMN"T0: CERTIFICATE Ol� INSURAAICE _ Approved as to Form:
C
(:ily of Huntington Coach
TO Gail Hutton,City Attorney
In".& R,-rl.Offiev CiTY OF HUNTINGTON BEACH, CALIFORNIA
I'. () Rex 190 �' (}
[hrn4nhton [icach,Cry r1264t1 A MUNICIPAL CORPORATION By: �Jel"`
This is to c^•'ify that the policies of insurance as described below have been issued to the insured by the undersigr.;:d and are in force
at this time. If these policies are cancelled or changed in such a manner that will affect this certificate,the insurance company agrees
to give 10 days prior written notice, by mail,to City of Huntington Beach,P.O.Box 711,Huntington Beach,California 92648.ALL
ITEMS MUST BE COMPLETED, ANY DELETION OR CHANGE IN THiS FORM SHALL BE SiGNED AND DATED BY AN
AUTHORIZED REPRESENTATIVE OF THE INSURANCE COMPANY AND MUST BE APPROVED IN WRITING BY THE CITY
ATTORNEY.
Name of Insured SHER FIVE POINTS
Address of Insured 200-112th Ave. NE, #213, Bellevue, WA 98004
Location of Work or Operations to be performed Loehmann' s Five Points Shopping Center
Main Street, Huntin_Pt-on 3eac , CA 926415
Description of Wjrk or Or r,Aions
POLFC-Y-15-ATES LIMITS OF LIABILITY NAME OF COMPANY
POLICIES IN FORCE POLICY NO. Effective Expiration In Thousands(000) (INS.)
GENERAL LIABILtTi' / l
DQ COMPREHENSIVE FORM )��o l rt �� �r I�/ $7
$500 OOU csL
DO PREMISES-OPERATIONS Each Occurence
j } EXPLOSION AND
COLLAPSE HAZARD
[ I UNDERGROUND HAZARD
VI PRODUCTS COMPLETED
OPERATIONS HAZARD
iXI CONTRACTUAL
INSURANCE
f ) BROAD FORM
PROPERTY DAMAGE
[A INDEPENDENT
CONTRACTORS
[)(I PERSONAL INJURY
AUTOMOBILE LIABILITY
( COMPREHENSIVE FORM
( 1 OWNED 3 CSL
Each Occurance
[ 1 HIRED
f I NON-OWNED
EXCESS LIABILITY
[ J UMBRELLA FORM $
[ j OTHER THAN
UMBRELLA FORA
WORKERS'COMPENSATION
and
EMPLOYERS'LIABILITY
Additional Insured Endorsement:
The insurer agrees that the City of Huntington Beach and its City Council, and/or all City Council appointed groups,committees,
commissions,boards and any other City Council appointed body,and/or elective and appointive officers,servants or employees of the
City of Huntington Beach,when acting as such are additional insureds hereunder,for the acts of the insured,and such insurance shall
be primary to any insurance of the City of Huntington Beach,as their interest may appear.
Data -- . 18 AUTH RIZED REPRESENTA,�TIIVE.IOF INSURANCE COMPANY
INSURANCE COMPANY � 11y(taJ*vtiJC ZKK By -/�' �"�
Name ��=rr � Insun.� 1��a,ar^—� Address WOQ
t� CElrVrvrv.tnct. 1 )Juv¢>
Address n)70U R rtvrt�c^L �J City �[`u"w"�s.'' /�- 3031 k,
City 114 .'O.ljg 41 Telephone Loy) JSS'- CNOa
HOLD HARMLESS AGREEMENT
to be executed by insured)
The insured " agrees to protect,defend, indemnify,save, and (told harmless the City of Huntington Beach its
officers, agents, and employees against any fi 'ity, loss,damage,cost, or expense by reason of any and all liability, suit::, claims,
demands,judgments and causes of action caus d b insured,his employees.agen2s or any subcontractor or by any third party arising
out of or in consequence of the performance all or any oper ons or activity f r—w#isk—th certificate of insurance is furnished.
•(1)Sole Proprietorship 1(2)Partne i ) Cr ation 4) Other(state) Tenancy in Common
HOLD HARMLESS SIGNED: By thsured: ��_ Title
Nanagina Owner
t(All names shall be printed or pod R{)riald. Sher for SEER
below each signature.) IVE POINTuE
By insurod, Title
If Corporation,TWO Officars must sign,or present evidence of authorization to bind Corporation.